Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department (original) (raw)
2011, International journal of emergency medicine
A 70-year-old female presented to the emergency department with a 3-day history of intermittent dysphasia and right facial droop. Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained, and the patient was found to have meningeal carcinomatosis, also known as leptomeningeal metastases. Meningeal carcinomatosis is a rare metastatic complication of some solid tumors and hematopoietic neoplasms, and has a median survival rate of 2.4 months. The role of the emergency physician is to appropriately diagnose this condition, treat emergent side effects, provide symptomatic relief, and ensure multi-disciplinary management.
Sign up to get access to over 50M papers
Sign up for access to the world's latest research
Related papers
Meningeal carcinomatosis in solid tumors
The involvement of the leptomeninges by metastatic tumors can be observed in solid tumors, in which case it is termed meningeal carcinomatosis (MC), and in lymphoproliferative malignant disease. It is more common in breast and lung cancer, as well as melanoma, with adenocarcinoma being the most frequent histological type. MC is usually a late event, with disseminated and progressive disease already present and, it is characterized by multifocal neurological signs and symptoms. Diagnosis is based on the evaluation of clinical presentation, cerebrospinal fluid and neuroimaging studies.
Meningeal Carcinomatosis in Metastatic Prostate Cancer: A Case Report
The Prostate Journal, 1999
Leptomeningeal involvement of metastatic prostate cancer is a rare clinical entity. We report such a case, along with a summary of three previous cases where detailed clinical information is available. Seven additional cases (for a total of 10 cases) have been reported previously in the literature. It seems that this syndrome is associ-ated with changes in mentation, specifically without cranial nerve findings on physical exam. The physician should be alerted to the possibility of this clinical circumstance in metastatic prostate cancer patients with altered mental status.
Meningeal carcinomatosis as the initial manifestation of lymphoma
Journal of Negative and No positive Results, 2022
Introduction: Leptomeningeal carcinomatosis (LC) is diagnosed in 4-15% of cancer patients, and most cases (70%) are in the advanced phase of the disease. In only 5-10% of patients with LC, it is the initial manifestation of cancer. Case report: We present a case of a 46-year-old man with leptomeningeal carcinomatosis as the first manifestation of type B highgrade lymphoma. Cerebrospinal fluid (CSF) showed pleocytosis with a predominance of mononuclear cells, hyperproteinorrhachia, and glucose consumption. CSF cytology was negative for malignant cells in two samples. Magnetic resonance imaging and CSF flow cytometry gave the diagnosis. Discussion: LC is a diagnostic challenge. Differential diagnosis arises with infectious processes (tuberculosis) and autoimmune diseases. In cerebrospinal fluid, flow cytometry (FCM) has a higher sensitivity than cytology for the diagnosis of LC.
Adenocarcinoma lung presenting with meningeal carcinomatosis
Monaldi Archives for Chest Disease
Meningeal infiltration by malignant metastasis process without brain parenchymal involvement is very unusual event in patients with bronchogenic carcinoma. This manuscript describes a case of adenocarcinoma right lung in a 48-year old male having persistent headache. The cerebrospinal fluid cytology revealed the presence of metastatic deposits of adenocarcinoma lung that confirmed the diagnosis of meningeal carcinomatosis.
Intracranial metastasis or meningioma?
Surgical Neurology, 2002
Tagle P, Villanueva P, Torrealba G, Huete I. Intracranial metastasis or meningioma? An uncommon clinical diagnostic dilemma. Surg Neurol 2002;58:241-5.
BMC cancer, 2015
The incidence of meningeal carcinomatosis appears to be higher than in the past due to advances in neuro-imaging diagnostic techniques and improvements in cancer survival. Among solid tumors, breast cancer is the cancer most commonly associated with meningeal carcinomatosis, with an incidence rate of between 0.8 and 16 %. Aim of this study has been i) to evaluate the incidence of meningeal carcinomatosis in a continuous breast cancer unselected series treated in a dedicated Breast Unit and ii) to define the clinico-pathological and molecular parameters associated with meningeal carcinomatosis development. A retrospective series of 1915 consecutive patients surgically treated for breast cancer between 1998 and 2010 was collected. Clinico-pathological data were recorded from medical charts and pathological reports, including the date of development of symptomatic meningeal carcinomatosis. Meningeal carcinomatosis incidence was determined at both 5- and 10-year follow-ups. Three patien...
Neuroradiology, 1990
Four patients with leptomeningeal metastases documented by neuroradiological examinations are reported. All had central nervous system or systemic neoplasms and showed clinical signs of carcinomatous meningitis. Gadolinium-enhanced MR1 (Gd-MRI) disclosed for each patient pathological loci, allowing delineation of the extent of meningeal disease. Although non-specific, these findings, combined with the clinical context and CSF analysis, may lead to a rapid diagnosis and treatment of carcinomatous meningitis, even when malignant cells are not detected in the cerebrospinal fluid.
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.